Haven Care - Hounslow Branch

Haven Care - Hounslow Branch in a domiciliary care agency providing care and support to people living in their own homes in West London. At the time of our inspection, they were providing care to adults only. The majority of people were older adults. Some people were receiving reablement support for a 6 week period. The service is designed to provide people with support to regain independence and skills.

At the time of the inspection, the location provided care to four adults with a learning disability. We assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group. Although the support they provided in this area was limited and the majority of support they provided was to access social and leisure activities and not with personal care.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

At the time of our inspection, 151 people were receiving support with personal care.

People’s experience of using this service and what we found.

The service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture.

Right Support

People who were supported with medicines received safe and appropriate support with this. Risks to people's safety and wellbeing were assessed and planned for. These assessments included checking people's home environments to make sure they could be safely cared for. The provider created care plans which recorded people's individual needs and how these should be met. These were regularly reviewed and updated. People received the support they wanted and needed to prepare meals, access the community and at home. The provider supported people to have the maximum possible choice, control and independence be independent and they had control over their own lives.

Right Care

People were happy with the care and support they received. They had good relationships with the staff and felt involved in planning their own care. People told us their needs were met and choices were respected. They were supported to be independent when they wanted. The provider had procedures to help make sure staff were suitable when they recruited them. They supported staff to undertake a range of training and they regularly assessed their skills, knowledge and competencies.

Staff promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care. People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. The service had enough appropriately skilled staff to meet people’s needs and keep them safe. Staff assessed the risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.

Right culture

People received good quality care, support and treatment because trained staff could meet their needs and wishes. There were suitable policies and procedures for managing the service. The management team had a good knowledge of people they supported and staff. They carried out regular audits, checks and reviews of the service. People were able to give their feedback. This was listened to and acted on. There were suitable systems for dealing with complaints, accidents, incidents and safeguarding concerns. Lessons were learnt from these.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (Published 9 March 2021).

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Haven Care – Hounslow Branch is a domiciliary care service providing personal care and support for people in their own homes. The majority of people receiving support had their care funded by their local authority. They also provided short term care and support, alongside the treatment provided by the health authority, to people moving back home after an accident, hospital admission or operation. This type of support is known as reablement and is designed to help people to regain skills and confidence so that they can return to the lifestyle they had previously. At the time of the inspection the service provided support for approximately 147 people.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

The provider did not ensure people were always supported appropriately with their prescribed medicines to help protect them from the risk of harm.

Risk management plans were not always in place where an assessment of a person’s health and wellbeing had identified a specific issue and adequate information was not always provided for care workers to reduce possible risks. Improvements had been made in the recording and investigation of incidents and accidents.

Care workers had not always completed training the provider had identified as mandatory to support them in providing care to meet people's specific care needs in a safe manner.

The outcomes of complaints and the actions to be taken to reduce the risk of reoccurrence were not always communicated clearly to the person who raised the concern, so they knew their complaints had been appropriately addressed.

We have made a recommendation about the management of safeguarding concerns as the provider had records relating to reported safeguarding concerns but they did not always follow the Multi-Agency Safeguarding Adult’s Policy and Procedures to ensure safeguarding concerns are responded to appropriately.

In the main people were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. We have made a recommendation about ensuring the principles of the Mental Capacity Act were followed.

While people’s feedback suggest that they were getting the care they needed, care plans relating to people using the service were not always up to date and did not always reflect people’s care needs. This meant care workers were not always provided with all the information they needed to care for people. We have made a recommendation about the recording of contemporaneous records

People told us they felt safe when they received care in their home. An assessment of a person’s care and support needs was completed before any care visits started so the provider could ensure they could meet the person’s support needs.

The provider had made improvements to the processes for recruitment which helped them identify new care workers had the appropriate skills to provide care.

People told us they felt the care workers were kind, caring and treated them with respect. People’s religious and cultural beliefs were identified in the care plan.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 15 January 2020). The service remains rated requires improvement.

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvement. Please see the safe, effective, responsive and well Led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to safe care and treatment, management of complaints, good governance and staffing at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety and meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Haven Care – Hounslow Branch is a domiciliary care service providing personal care and support for people in their own homes. The majority of people receiving support had their care funded by the local authority. They also provided short term care and support, alongside the treatment provided by the health authority, to people moving back home after an accident, hospital admission or operation. This type of support is known as reablement and is designed to help people to regain skills and confidence so that they can return to the lifestyle they had previously. At the time of the inspection the service provided support for approximately 120 people. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

Medicines were not always managed in a safe way to ensure they were administered appropriately and as prescribed.

When a specific issue had been identified during an assessment of a person’s care needs a risk management plan had not always been developed to provide care workers with adequate information to enable them to reduce the risks.

The provider did not record and investigate when an incident and accident occurred involving a person receiving support.

There was a procedure in place to investigate concerns regarding the care provided but this was not always followed to ensure actions were taken to reduce the risk of reoccurrence.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

The provider could not demonstrate that care workers had completed aspects of the training courses which enabled them to meet people’s specific care needs in a safe manner.

Care plans relating to people using the service did not always provide accurate information relating to the care and support they needed. Therefore, care workers did not have all the information they needed to care for people.

Complaints were not always recorded, nor was action identified or taken to respond to the issues raised.

The provider had a range of audits in place, but the audit in relation to care plans did not provide appropriate information to identify where actions for improvement were required.

The provider had processes for recruitment, but this was not robust enough to ensure care workers had the appropriate skills to provide care in a safe manner.

People told us they felt safe when receiving care. An assessment of a person’s care and support needs was completed before they started to receive care from the service.

People felt the care workers were caring and kind and treated them with respect and dignity. The cultural and religious preferences and needs were identified in people’s care plan.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 15 June 2017).

Why we inspected

This was a planned inspection based on the previous rating. We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well led. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified breaches in relation to person centred care, the need to consent, safe care and treatment, safeguarding service users from abuse and improper, good governance, staffing and fit and proper persons employed at this inspection at this inspection.

Please see the action we have told the provider to take at the end of this report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Haven Care – Hounslow Branch provides personal care to people in their own homes. They also offer a range of other services including cleaning, shopping, outreach services and companionship. At the time of inspection there were 120 people using the service, the majority of whom were funded by Hounslow local authority or CCG.

The service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager had been in post since the service registered with the Care Quality Commission.

People said their care workers made them feel safe. Staff understood what constituted abuse and were clear they would report any concerns. Procedures were in place to safeguard people against the risk of abuse.

Staff recruitment procedures were in place and were being followed. Staff were available to meet the needs of people using the service and systems were in place to ensure people received their care in a timely way.

Risks were identified and assessed and action plans put in place to minimise them.

Staff received training in medicines administration and procedures for safe medicine management were being followed.

Infection control was being safely managed by the service.

Staff received training and supervision to provide them with the knowledge and skills to care for and support people effectively.

Staff were aware to report any concerns regarding people’s capacity to make decisions for themselves. They respected people’s rights to make choices about the care and support they received.

Staff supported people with preparing simple meals if they required it.

Staff knew to observe for changes in people’s health and systems were in place to alert healthcare professionals if people required their input.

Staff treated people with dignity and respect and were professional, friendly and kind. Staff took the time that was needed to meet people’s care and support needs.

The service respected people’s rights to choose and matched people with care workers taking into consideration their gender and also any religious and cultural needs.

Care records had been formulated with input from people so their wishes for their care and support were identified and included. Staff read the care records so they could provide the care and support people wanted and needed.

Procedures for raising complaints were in place and people were able to raise any concerns so they could be addressed.

People and staff all said they would recommend the service to others. People were happy with the service they received, were being listened to and had their needs met. Care workers felt very well supported by the management team and office staff and said communication was good.

Systems for monitoring the service were in place and being followed effectively. The provider worked continually to improve the service provision for people and for staff.